Can profitability and religious mission be integrated?

Officials have begun to quantify the fallout from the demise of St. Vincent's Hospital in Manhattan. When New York's last acute care Catholic hospital effectively closes its doors tomorrow, more than 3,500 employees will be out of a job, and more health layoffs throughout the city may be on the horizon, Alan Aviles, president of the Health and Hospitals Corp., which runs the city's public hospitals, told the Wall Street Journal.

Despite optimism from the United Hospital Fund and statements from neighboring hospitals that they will give preference to displaced workers [1], one nurse told WSJ that many employees, from housekeepers to surgeons, are having difficulty finding work.

State officials said it's possible more healthcare layoffs could come in New York state if the legislature slices Medicaid reimbursement rates. That would especially hit hospitals that care for a large share of the poor, particularly public hospitals, reports the newspaper.

Meanwhile in Boston, six Catholic Caritas Christi hospitals are poised to enter the for-profit sector as part of an $830 million acquisition by Cerberus Capital Management [2]. Although the New York private equity firm has said it has no intentions of altering the hospitals' religious mission and philosophy, the for-profit conversion of Saint Vincent's hospital in Worchester offers insight as to what Catholic care under corporate ownership may look like, reports the Boston Globe. "It also sheds light on a national debate about whether for-profit Catholic healthcare is an oxymoron, or whether profitability and religious mission can be integrated," the Globe states.

After transferring ownership among various for-profit companies for the past 14 years, Saint Vincent has been owned by Vanguard since 2005, and currently boasts a profit margin of four to five percent. And despite outward signs that the hospital's religious identity remains intact, the nurses union, which has clashed repeatedly with hospital management, says Vanguard's relentless focus on profitability has undermined patient care. In 2008, the hospital had 25 serious medical errors or accidents, more than any other in the state, though officials note that hospital safety has improved over the past year.

While some experts insist that profit and healthcare shouldn't mix, John M. Haas, president of the National Catholic Bioethics Center, says a carefully written stewardship agreement could go a long way toward heading off some of the risks. It could, for example, require an annual audit of all medical procedures to make sure the hospital follows the Catholic directives, or spell out that the CEO would lose his job if the hospital did not maintain its level of charitable care.

To learn more:
- read this Boston Globe article [3]
- read this Wall Street Journal piece [4]